Medical Billing Expert 521470 AL

Expertise Description

With over 25 years experience in Medical Billing, I am an expert on Revenue Cycle Management with an expertise in coding, auditing, practice management, risk adjustment/RADV Audits, CMS, Medicaid, Workers Comp, demographic entry, payment posting and adjustment, patient statements, paper and electronic claims, claim follow-ups, practice management system table clean-up, and ASC charge master analysis. I have additional knowledge in coding for Anesthesia, Pain Management, Neurology, OBGYN Laboratory, Ambulance, General Surgery, Physical/Occupational/Speech Therapy, Chiropractic, IDTF, Radiology, and Gastroenterology. I am offering my services as a Medical Billing expert witness.

Areas of Expertise

Consulting Experience

My consulting experience includes projects for Revenue Cycle Management. The usual scope of a project consists of a review of outstanding insurance balances sorted by date of service and rendering provider of service. The next step would be to review the outstanding CPT / ICD-I O codes as it relates to the insurance company’s local coverage determinations. Clearinghouse review for submitted claims/ rejected claims. Provider fee schedule review based upon locality and zip code. Patient insurance eligibility status and Prior authorization status. All these processes are reviewed to report back to the physician the status of the revenue cycle.

Professional Experiences

My professional experience includes over two decades years in the healthcare field. My career began as a duly licensed insurance/securities agent in the individual and small business Texas marketplace. I am a subject matter expert on Revenue Cycle Management and have served as CEO of a company that offers Full Revenue Cycle Management, CPT/ICD-10 Coding, Practice Management Consulting, compliance and Education. I also have extensive experience in Anesthesia and Pain Management across all areas of expertise. I have presented topics on RCM, Practice Management, Anesthesia Coding and Risk Adjustment.

Licenses Certifications

Certified Professional Coder / AAPC
Certified Risk Adjustment Coder / AAPC